• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7237-7241
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• 2013

Background: Smokeless tobacco use in South Asia is believed to be a significant contributor to morbidity and mortality. In India, only a few studies involving health educational intervention by health care providers have demonstrated reduction in smokeless tobacco usage. In the present study we assessed the cessation efforts towards smokeless tobacco by physicians in two high tobacco prevalence states of India. The study also identified opportunities and barriers for integration of tobacco cessation services in routine practices of physicians. Materials and Methods: This mixed method study involved qualitative (phase I) and quantitative research study (phase II). In phase I, 59 in-depth interviews with physicians were conducted. In phase II, a quantitative study conducted among 238 physicians. An inductive approach was followed to analyze qualitative data using ATLAS. Ti software. The Chi-square test was employed to test the association between different variables of interest using SPSS version 17. Results: The majority of physicians related only respiratory problems and cancer with smokeless tobacco. Other major health effects like cardio-vascular problems, oral diseases, and effects on reproductive and neonatal health were recognized only by a few physicians. The age-group of 10-19 years was identified as most vulnerable to smokeless tobacco use. Less than one-third of physicians reported recording smokeless tobacco history of all patients. Findings indicated that less than half of physicians provided information on harmful health effects of smokeless tobacco with regard to specific diseases. Conclusions: The study revealed a low level of knowledge of physicians about harmful effects of tobacco and their suboptimal engagement in tobacco control practices. The study indicates the need of capacity building initiatives to equip physicians with skills in tobacco cessation.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.487-494
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• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.59-70
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• 2008

Purpose: Purposes of this study were to promote understanding on mutually informed consent by comparing and analyzing the perception and experience of informed consent among physicians, nurses, and patients. Method: Participants in the study were 145 physicians, 300 nurses, and 178 patients from eight hospitals in Busan. To examine their understanding and experience with informed consent, all participants responded to a questionnaire. The collected data were analyzed using SPSS/PC 12.0 program. Results: On the necessity of informed consent, the affirmative percentages were 95.9% for physicians, 99.0% for nurses and 84.8% for patients. As to the most important reason for informed consent 47.6% of the physicians and 64.3% of the nurses answered 'because it is an occupational and ethical duty', while 46.6% of the patients answered 'because it is protection for physicians'. Regarding the legal decision maker for informed consent, 33.1% of the physicians, 27% of the nurses, and 42.1% of the patients answered that the legal decision-making right belonged to the 'patient'. The agreement rate on the necessity of providing a comprehensive explanation about informed consent was 89.0% for physicians, 98.3% for nurses, and 96.1% for patients. Conclusion: Most physicians, nurses, and even patients have inaccurate perceptions and inappropriate experience with informed consent.

• Journal of Preventive Medicine and Public Health
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• v.23 no.4 s.32
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• pp.428-435
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• 1990

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows : 1) Total number of respondents was 405 ; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized n surge, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's ma discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.

• Health Policy and Management
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• v.26 no.3
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• pp.219-225
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• 2016

Background: Intention to leave was an important managerial issue among physicians working in public health centers. This study was conducted to explore the relationship between job participations and intention to leave among physicians working in health centers. Methods: A cross-sectional questionnaire survey was conducted to gather information about job participation, intention to leave and demographics among physicians (n=243) in public health centers in Korea. Job participation was measured by 15 items categorized 3 dimensions. Multiple regression analysis was performed to determine the effect of job participation on intent to leave among physicians working in public health center. Results: Participation of medical treatment and administrative job were significantly associated with intention to leave adjusted for sex, age, income, working area, working duration, tenure, and overall job satisfaction. Therefore, physicians who actively participated in administrative job showed a lower turnover intention. Physicians who actively participated in medical treatment job had a higher quit intention. Conclusion: To retain qualified physicians in public health center, education should be reinforced to physician for administrative capacity building.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.76-91
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• 1998

Background : The purpose of this study was to understand general attitudes of physicians toward hospital quality improvement activities who have been members of QA committee in 32 Korean university hospitals. Methods : A postal survey about opinions of hospital quality improvement activities and desirable policy directions was sent to 328 QA committee member physicians. The questionnaires were composed of 48 items. In total 152 physicians responded to this survey(response rate: 49.3%). This study was carried out from January to February 1996. Results : Most physicians(97.5%) recognized the necessity of hospital QA activities. The most dominant supporting reason for quality activities was to improve clinical outcome. Two thirds of physicians regarded their own hospital activities for quality improvement as inactive. They considered that the obstacles were too little concern(33.6%), unclear objectives(28.9%), lack of human resources(14.3%), and insufficient education and training for quality improvement(10.1%). The most favoring policy among respondents was to give health care providers economic incentives. Provision of education and training for implementing quality improvement was the next to it. Physicians revealed their preferences for professional society, government, health insurance societies, consumer groups, hospital labor unions, and mass media in sequence as sponsoring agencies for hospital accreditation program. Conclusion : These study suggested that the concrete means for motivating physicians and promoting constructive partnership among related parties should be developed in order to activate current hospital quality activities in Korea.

• Health Policy and Management
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• v.11 no.4
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• pp.70-87
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• 2001

The purpose of this study was to identify health care providers' perceptions about the goal achievement and benefit/loss caused by the separation policy of drug prescribing and dispensing after the policy implemented on July 1, 2001. Uslng stratified sampling method based on the administration area, Ku, 315 physicians and pharmacists were sampled from the rosters of physician and pharmacist association in the city of Busan on 2001. There were 122 and 115 responses from physician and pharmacist sample, respectively. 78.3% of physicians and 50.4% of pharmacists evaluated that the goal of the policy was not achieved. Moreover, 75.3% of physicians and 40.7% of pharmacists did not support the policy. Most physicians and pharmacists considered preventing the citizens with drug abuse and misuses as the most important benefit derived from the policy. However, physicians and pharmacists concerned over raising health care cost that could be patients' burden. The most important physicians' benefit derived from the policy was free choice of all possible medicine that might result in effectiveness of medication. In physicians' the most important loss, most physicians worried about that breaking traditional patient and physician relationship might cause physicians' authority in treating diseases to be damaged. Pharmacists considered the most important policy benefit as hiked social status resulted from enforcement of profession due to the policy whereas they considered the most significant loss as expected financial problems of small pharmacies compared to that of large pharmacies or pharmacies adjacent to hospitals. In the current problems of the policy, physician and pharmacists blamed the government for inadequate preparations of the policy implementation. Physicians and pharmacists also considered citizens' mature attitudes toward the policy as a crucial success factor.

• Korean Medical Education Review
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• v.24 no.3
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• pp.240-249
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• 2022

This study explored the public's response to an incident involving publicity about how physicians broke bad news to a terminal cancer patient by analyzing 1,960 comments from three online news websites that reported on this event using Braun and Clarke's theme analysis methods. Three themes and 10 subthemes emerged from the public's responses to the way the physicians broke the bad news. Theme 1 (a physician is a person who tells the facts) contained the following subthemes: physicians are responsible for delivering facts, but it is a matter of consideration for patients to deliver bad news to them, empathy and consolation should be expected from people other than physicians, and physicians who say what patients want to hear are cheaters. Theme 2 (there is a problem with physicians) included the following subthemes: the physicians' empathy or personality and problems with their communication methods. Theme 3 (there are obstacles to communication with dying patients) had the following subthemes: physicians become emotionally dull and find it very stressful to break bad news, giving hope to dying patients can lead to medical disputes, and empathy and consolation are also costly. When breaking bad news, the physicians delivered factual information, but they did so inappropriately, and emotional support for the patient was insufficient. In medical communication education, it is necessary to emphasize training in emotional support. In the medical field, an environment should be created where physicians can communicate as they have learned.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.39-41
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• 2005

• Korean Medical Education Review
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• v.15 no.2
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• pp.61-68
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• 2013

During the Japanese colonial period in the Korean Peninsula, Chosun (ethnic Korean) physicians were trained in vocational clinical schools, but Japanese physicians in medical school. Therefore, the Japanese government treated the Japanese physicians as medical doctors but Chosun physicians as dealers or traders in clinical services. This colonial discriminatory policy became a habitual concept to Korean physicians. Because of these traditional concepts regarding physicians, after the colonial period, the newly established Korean government also had the same concept of physicians. Therefore, in 1952, the Korean graduate medical education system was launched under a government clearance system with the claim of supporting medical specialties as clinical dealers or clinical businesspeople. During the last 60 years, this inappropriate customary concept and the unsuitable system have evolved into medical residency training education, and then into graduate medical education. Today graduate medical education has become inextricably linked to postdoctoral work in Korean hospitals.